The pitch for The Big Sick might sound like a tacky weepie you’d have been afraid to watch on TV in the 1990s. But it’s hard to do justice to the balancing act that the creators of this singular comedy have achieved. Based on events in the life of star Kumail Nanjiani (who co-wrote the screenplay with wife Emily V. Gordon), it starts as a lighthearted, freewheeling opposites-attract rom-com and then heads into surprisingly grim territory — without ever betraying its wild sense of humor.

Film Details

Nanjiani plays himself, a struggling comic and Uber driver; the exceptional Zoe Kazan plays Emily, a psychiatry student. At first, their common challenge is a mutual antipathy toward long-term relationships. She’s busy and divorced; he’s from an immigrant family that keeps trying to set him up with young, eligible Pakistani women. After they become an item, Kumail continues not to tell his parents about the new love in his life, which in turn leads to a nasty breakup with Emily. Then, suddenly, she’s in the emergency room with a bad case of the flu, and Kumail is the only one around to be by her side.

Her condition worsens, and a doctor asks him to sign a form allowing her to be put into a medically induced coma. Soon, Emily’s parents (Ray Romano and Holly Hunter, both fantastic) come to town. Trouble is, unlike Kumail, Emily shares everything with her parents, and her mom and dad have heard all about what a dick this young man has been to their daughter. The excruciating period of waiting that ensues forces Kumail and the parents together, even as Emily lies perilously close to death and needs more and more medical intervention.

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Even after it becomes a story about a person in a coma, the film is hilarious — I daresay it gets even funnier. Director Michael Showalter and Nanjiani and Gordon find bracing, unpredictable humor in the spectacle of an ex-boyfriend and two harried parents stuck together in the most awkward circumstances. At one point, Kumail invites the skeptical parents to watch his stand-up act; when a racist bro heckles him from the audience, Emily’s mom suddenly leaps to Kumail’s defense — the defense of the man who broke her daughter’s heart — and all hell breaks loose. This bizarrely funny moment of solidarity and horror might be cheap in another context; here, it seems dead-on, because the filmmakers never lose sight of their characters’ real suffering. If anything, that suffering — the unthinkable anxiety of worrying you might lose your child — heightens the absurdity.

The cast helps tremendously. Nanjiani initially brings a detached, self-deprecating quality to his performance; he’s a wise guy walking through life as if he were living in his own stand-up act. His is the dilemma of the too-cool-for-school guy who’s not prepared for the fact that sometimes shit gets real. Hunter and Romano make a fine study in contrasts. She’s fast as lightning and always on the lookout for an outrage, a slight, a cause. He’s unassuming to a fault, applying the same devil-may-care delivery to insights both mundane (“You go online, they hate Forrest Gump. Fucking best movie ever made”) and profound (“Being a parent. It’s a nightmare. Loving somebody this much sucks”).

But Kazan’s performance might be the key here. Her Emily is vivacious, complicated, anxious, forthright — and once she’s mostly removed from the narrative, her presence hangs like an insistent ghost over the other characters. Like them, we want her to get better so we can have her back. Over and over, the movie proves that a filmmaker can get away with any tonal shift, any kind of joke, so long as the focus remains on people.

The Big Sick was produced by Judd Apatow, and it shares with some of Apatow’s recent films an attempt to break out of the bubble of improvisatory comic fancy and locate itself amid the messiness of real life. (Even the very direct title has an Apatowian echo, a plainness to match his own Funny People and This Is 40.) And, not unlike some other Apatow productions, it has its saggy moments: The various bits of (probably improvised) banter between Nanjiani and his fellow stand-up comics are pretty funny at first but grow tiresome. Still, those are minor concerns. For most of its running time, The Big Sick astutely pulls you between the twin poles of agony and glee.